抄録
A 73-year-old female was admitted on December 12, 1978, because of dizziness, tinnitus and general malaise. Physical examination revealed pale conjunctiva, hepatosplenomegaly and generalized lymphadenopathy. The hemoglobin was 6.1 Gm/100 ml., red cell count 3,000,000 per cu. mm., hematocrit 18 per cent and reticulocytes 3.4 per cent. The white cell count was 590,000 per cu. mm. with 1.0 per cent myeloblasts and the maturation of the myeloid series was normal. The erythroblasts were seen 17 per 200 white cells. The platelet count was 115,000 per cu. mm.
A sternal marrow aspirate revealed hypercellular marrow with normal megakaryocyte count and marked myeloid hyperplasia. Axillary lymph node biopsy material revealed a severe infiltration by the mature granulocytes, small grouped erythroblasts and atypical megakaryocytes.
The Philadelphia chromosome was negative. The neutrophil alkaline phosphatase score was within normal limits. The hemoglobin F was 0.6 per cent.
She suffered from acute renal failure before the initiation of the antileukemic therapy and died two weeks after admission.
On autopsy infiltration of the leukemic cells was noted in almost all organs with the granulocytes of every maturation stage, erythroblasts and atypical megakaryocytes. No other malignant changes were observed on autopsy.
